T-Cell Lymphoma: Treatment Options
Since there are so many different types of T-cell lymphoma, treatment varies widely. Standard lymphoma therapies may include chemotherapy, immunotherapy (like antibody drug conjugates) radiation, stem cell transplantation, and surgery. Patients diagnosed with rare forms of lymphoma should consult their medical team to find new promising therapies or to enroll into clinical trials.
Treatments aimed at the skin, such as topical corticosteroids, topical retinoids, topical chemotherapy, ultraviolet light therapy, or electron beam therapy (a type of radiation that does not penetrate to internal organs), are effective for many of the slow-growing T-cell lymphomas that appear in the skin (CTCL).
In addition, a procedure called extracorporeal photopheresis (ECPP) is approved to treat people with CTCL. For this procedure, blood is removed from the patient and treated with ultraviolet light, and with drugs that become active when exposed to ultraviolet light. Once the blood has been treated, it is then returned back into the patient’s body.
When systemic chemotherapy treatments are appropriate, initial treatment is typically a combination chemotherapy regimen, such as CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone), CHOEP (CHOP plus etoposide) or EPOCH (etoposide, vincristine, doxorubicin, cyclophosphamide, and prednisone), or other multidrug regimens. Treatments might vary widely depending on the subtype of lymphoma that you have. In some cases, it may be determined that transplantation is the most appropriate approach to treatment.
Treatments Under Investigation Treatment options for the different types of T-cell lymphomas are expanding as new treatments are discovered and current treatments are improved. Treatments currently being investigated singly or in combination include:
- Alisertib (MLN8237)
- Bendamustine (Treanda)
- Bortezomib (Velcade)
- Brentuximab vedotin (Adcetris) (approved for relapsed or refractory ALCL only)
- Crizotinib (Xalkori)
- GDP (gemcitabine, dexamethasone, and cisplatin)
- Lenalidomide (Revlimid)
- Nivolumab (Opdivo)
- Panobinostat (Farydak)
- Pembrolizumab (Keytruda)
In addition, a number of promising clinical trials are exploring combinations of these new agents which in some cases may be more active than the single agent alone. It is critical to remember that today’s scientific research is continuously evolving. Treatment options may change as new treatments are discovered and current treatments are improved.